Vertigo, unspecified
Complaints of dizziness or unsteadiness without an identified cause. Requires differential diagnosis: peripheral causes (BPPV, Meniere disease, vestibular neuritis), central causes (stroke, tumor), orthostatic and psychogenic causes.
ICD-10 R422 drugs
Also known as: Non-specific dizziness
Marketing claims without evidence base
The drug is promoted for these uses outside international guidelines. Each entry below is analyzed against AEMPS, FDA, EMA, Cochrane and major RCTs.
- DDimenhydrinateNot recommended · First-generation antihistamine, ethanolamine derivative, antiemeticA motion sickness tablet is often kept at home «for dizziness in general». Different kinds of vertigo are treated differently, and dimenhydrinate does not fit all of them. The AEMPS ficha técnica limits the indication to motion sickness symptoms rather than vertigo of any origin. In benign paroxysmal positional vertigo repositioning manoeuvres help, and vestibular suppressants prevent the brain from adapting and drag recovery out. In vestibular neuritis such drugs are used in the first days and stopped early so that compensation is not held back. The dangerous case stands apart: sudden vertigo with double vision, limb weakness, speech disturbance or headache needs urgent care, because it may be a stroke. If dimenhydrinate was prescribed for long-standing dizziness without investigation, consider seeking a second opinion.
- FVinpocetineNot recommended · Psychostimulants and nootropics. Other psychostimulants and nootropicsEvidence tier F. Vinpocetine has no evidence base in vertigo. International vertigo guidelines (Barany Society, AAO-HNS 2017 BPPV update) do not mention the drug. Vertigo requires targeted diagnosis: canalith repositioning for benign paroxysmal positional vertigo, vestibular suppressants short-term plus vestibular rehabilitation for vestibular neuritis, betahistine and dietary measures for Meniere disease, treatment of underlying psychiatric condition for persistent postural-perceptual dizziness. Generic "vasoactive" prescribing for "dizziness" delays the correct workup.
How to read tiers A–F
Evidence tiers belong to the drug-indication pair, not to the drug as a whole: the same substance can be A for one condition and F for another.
- AStrong evidence – first or second line in international guidelines
- BRecommended in selected cases
- CStudy data contradict each other
- DBenefit not proven, no documented harm
- FDocumented harm, or risk without benefit